tbuckley/cabot-search huggingface dataset:
The liver adventures of bariatric endoscopy
Authors: Ivo Boškoski
Journal: Endoscopy (2023)

In the past few decades, endoscopy has overtaken many procedures that were routinely done surgically; the list is impressively long. With the advent of suturing devices, endoscopists are not only capable of closing defects, fixing stents, etc. but are also capable of suturing and remodeling organs such as the stomach. Bariatric endoscopy is a newborn that already runs by its own legs. The massive expansion of bariatric endoscopy is driven by need: today, one-third of the world's population is overweight or obese and has associated nonalcoholic fatty liver disease (NAFLD) [1]. Bariatric surgery is very effective but invasive; thus, more and more patients and physicians are looking into less invasive treatments such as bariatric endoscopy, specialized diets, lifestyle coaching, and glucose-dependent insulinotropic polypeptide–glucagon-like peptide-1 (GLP-1) receptor agonists [2]. Bariatric endoscopy intended as gastric plication, or better, endoscopic sleeve gastroplasty (ESG), is becoming very attractive to patients; it is scarless, gives less pain, and is associated with fewer short- and long-term complications, and recovery is fast. However, procedures are less effective in patients with higher body mass index (BMI) and more effective in those with lower BMIs. ESG fits vast types of patients, for example, those in whom conservative medical interventions have failed but who are unfit for or decline bariatric surgery, and also pediatric and geriatric populations [3] [4] where surgery is unsuitable.
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients
Authors: Helena Escolà, Beatriz Llombart, Alba Escolà-Rodríguez, Lucía Barchino-Ortiz, Joaquim Marcoval, Inmaculada Alcaraz, Sònia Beà-Ardébol, Agustí Toll, Román Miñano-Medrano, Pedro Rodríguez-Jiménez, María López-Nuñez, Carla Ferrándiz-Pulido, Ane Jaka, Emili Masferrer, Rafael S. Aguayo-Ortiz, Mireia Yébenes, Jorge Arandes-Marcocci, Verónica Ruiz-Salas, Lucía Turrión-Merino, Miquel Just, Júlia Sánchez-Schmidt, Lorena Leal, Fátima Mayo-Martínez, Lara Haya-Martínez, Alejandra Sandoval-Clavijo, Giulia Greta Dradi, Yolanda Delgado, Júlia Verdaguer-Faja, Daniel López-Castillo, Ramon M. Pujol, Gustavo Deza
Journal: Journal of the American Academy of Dermatology (2023)
Physiological Functions of RNA-Binding Motif Protein 3
Authors: Maohua Wang, Haizhou Xiang, Jianguo Feng, Jun Zhou, Lisirui Ge, Maohua Wang, Qiaoli Yuan, Xingchen Zhou
Journal: International Journal of Surgery (2023)

RNA-binding motif protein 3 (RBM3) is a cold stress-induced glycine-rich RNA-binding protein that plays a crucial role in regulating global protein synthesis and is involved in cold stress-induced responses, neuroprotection, cytoprotection, antiapoptotic processes, and cell proliferation. RBM3 plays an essential role in tumor progression and metastasis. In this review, we explored the structure, dynamic distribution, neuroprotective functions under mild hypothermia, and cytoprotective functions under adverse stress conditions of RBM3, as well as its regulatory role in tumor progression and metastasis based on findings from recent related research.
Abstract 13060: Prognostic Significance of Arterial Stiffness and Vascular Calcification in Patients With Coronary Artery Disease After Percutaneous Coronary Intervention
Authors: Gerasimos Siasos, Evangelos Oikonomou, Marina Zaromitidou, Konstantinos Maniatis, Eleni Kokkou, Alexis Antonopoulos, Theodoros Zografos, Konstantinos Mourouzis, Sotiris Tsalamandris, Stathis Dimitropoulos, Konstantinos Zisimos, Maria Anastasiou, Athanasios G Papavassiliou, Dimitris Tousoulis
Journal: Circulation (2015)

Introduction: Coronary atherosclerosis is the pathophysiologic background of coronary artery disease (CAD). Arterial stiffness and vascular calcification significantly contribute to coronary atherosclerosis progression. Hypothesis: Arterial stiffness and serum osteoprotegerin (OPG) levels are associated with cardiovascular prognosis in patients with stable CAD after percutaneous coronary intervention (PCI). Methods: We followed up prospectively (median time 40months), 220 consecutive subjects with stable CAD (mean age: 62±9years) after successful PCI. Carotid femoral pulse wave velocity (PWV) was measured as an index of arterial stiffness. OPG plasma levels were measured as a biomarker of vascular calcification. The primary end point was the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke or hospitalization for cardiovascular causes. Results: During the follow-up period 66 patients presented the primary composite endpoint. There was no difference in age, body mass index, female gender, diabetes and hypertension, between the subjects who presented the primary end point compared to subjects free of cardiovascular events (p=NS for all). Subjects who present the primary end point compared to those free of cardiovascular events were more often active smokers (p=0.03), had higher prevalence of 3 vessels CAD (p=0.03) and lower left ventricle ejection fraction (p=0.07). Importantly, subjects who present the primary end point, compared to subjects free of cardiovascular events, had significantly increased PWV (9.45±2.48m/sec vs. 8.50±1.90m/sec, p=0.005) and OPG levels (4.21±2.19pmol/L vs. 3.12±1.74pmol/L, p=0.002). Finally, a cox regression model revealed that the primary end point was significantly associated with PWV (Hazard ratio=1.34 95%CI: 1.09-1.64, p=0.005) and OPG levels (Hazard ratio=1.23 95%CI: 1.039-1.45, p=0.02) even after adjustment for confounders such as age, sex, smoking habits, ejection fraction, extent of CAD, hypertension and diabetes. Conclusions: Increased arterial stiffness and vascular calcification, estimated by serum osteoprotogerin levels, are significant determinants of adverse cardiovascular events in subjects with established CAD after PCI.
Abstract 16411: Can the Types of Coronary Artery Disease Severity be Predicted Using Any Parameters of Brachial Ultrasonography and/or Carotid Ultrasonography?
Authors: Hiroki Teragawa, Yuichi Fujii, Yuko Uchimura, Tomohiro Ueda
Journal: Circulation (2015)

Introduction: It has been reported that the flow-mediated dilatation (FMD) of the brachial artery on brachial ultrasonography and carotid intima-media thickness (IMT) on carotid ultrasonography correlate with the presence of coronary artery disease (CAD). Hypothesis: However, it is not clear whether CAD types can be detected using these techniques. We examined whether CAD types can be detected using brachial and/or carotid ultrasonography. Methods: Four hundred fifteen patients (mean age 68 years, 266 men) who underwent coronary angiography (CAG) during the evaluation of CAD were enrolled. Each patient underwent brachial and carotid ultrasonography before CAG. On brachial ultrasonography, FMD) and nitroglycerine-induce dilation (NID) were measured. On carotid ultrasonography, maximum IMT, the presences of carotid plaque (&gt;1.1 mm) and calcification were measured. On coronary angiography, if organic coronary stenosis was absent, a spasm provocation test was performed to confirm the presence of vasospastic angina (VSA). According to the CAG results, patients were divided into three subgroups: Group I, patients with organic coronary stenosis (n = 244); Group II, patients with VSA without organic coronary stenosis (n = 98); and Group III, patients without organic coronary stenosis or VSA (n = 73). Results: FMD was lower in Groups I (3.2% ± 0.3%) and II (3.2% ± 0.4%) than in Group III (4.5% ± 0.4%, p &lt; 0.05), and NID were lower in Group I (12.1% ± 0.4%) than in Groups II (14.6% ± 0.6%) and III (15.6% ± 0.7%, p &lt; 0.0001). Max IMT was higher in Group I (2.38 ± 0.06 mm) than in Groups II (1.61 ± 0.09 mm) and III (1.56 ± 0.10 mm, p &lt; 0.0001). The presence of both carotid plaque and calcification was higher in Group I (93% and 43%, respectively) than in Group II (74% and 19%, respectively) and III (60% and 19%, respectively, both p &lt; 0.0001). Logistic regression analysis demonstrated that carotid plaque (p = 0.0162), carotid calcification (p = 0.0011) and lower NID (p = 0.0011) were predictors of the presence of Group I, whereas lower max IMT (p = 0.0002) was one of predictors for the presence of Group II. Conclusions: These findings suggest that brachial and/or carotid ultrasonography before CAG may provide important diagnostic information regarding CAD types.
Abstract 11818: Mitral Valve Repair for Secondary Mitral Regurgitation In Non-ischemic Dilated Cardiomyopathy is Associated With Left Ventricular Reverse Remodelling and Increase of Forward Flow
Authors: Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Journal: Circulation (2015)

Introduction: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. Accordingly, the present study evaluated the effect of mitral valve repair on LV performance in this subset of patients. Methods: Seventy-six patients (65±14 years old, 43% male) with non-ischemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated. Transthoracic echocardiography was performed at baseline, discharge and 6-months post-repair. Results: After mitral valve repair, LVEF and LV global longitudinal strain (GLS) corrected for LV end-diastolic volume remained unchanged over time (p=0.90 and p=0.96 respectively). In contrast, LV forward flow increased significantly over time (stroke volume index: from 20±7 to 29±8 and 26±8 ml/m2, p&lt;0.001; cardiac index: from 1.50±0.44 to 2.36±0.60 and 2.01±0.48 L/min/m2, p&lt;0.001) (Figure). In addition, LV end-diastolic and end-systolic volume index significantly reduced over time (from 87±42 to 70±33 and 75±39 ml/ m2, p&lt;0.001; and from 60±35 to 50±30 and 53±36 ml/ m2, p=0.004, respectively). These changes were independent of the type of repair. Conclusions: Surgical and transcatheter mitral valve repair for secondary MR in patients with non-ischemic dilated cardiomyopathy improved LV forward flow and induced LV reverse remodelling but did not change LV systolic function.
Abstract 12185: Complete Disruption of All Nitric Oxide Synthases Markedly Reduces Cerebral Infarct Size After Middle Cerebral Artery Occlusion in Mice
Authors: Masato Tsutsui, Kubota Haruaki, Katsuhiko Noguchi, Toshihiro Matsuzaki, Fumiya Hattori, Mayuko Sakanashi, Mika Kina-Tanada, Masayoshi Ishida, Junko Nakasone, Hiroaki Shimokawa, Yusuke Ohya, Kazuhiro Sugahara, Manabu Kakinohana
Journal: Circulation (2015)

Background: The role of each nitric oxide synthase (NOS) isoform in cerebral infarction has been studied in individual NOS isoform-deficient mice. It has been reported that, in a model of middle cerebral artery occlusion (MCAO), neuronal and inducible NOSs exacerbate cerebral infarction, whereas endothelial NOS conversely alleviates it. Although the role of the whole NOSs system in cerebral infarction has been examined in pharmacological studies with non-selective NOS inhibitors, the results are quit inconsistent, possibly because of non-specificity of the agents. In this study, we addressed this point in mice in which all three NOS genes are completely disrupted. Method and Results: We newly generated triple NOSs -/- mice and wild-type littermates by crossbreeding single NOS -/- mice. Transient (1 hour) or permanent MCAO was performed in male triple NOSs -/- and wild-type mice at 8-12 weeks of age (n=8-11). There was no anatomical difference in the structure of cerebral arteries between the triple NOSs -/- and the wild-type mice. Reductions in cerebral blood flow during MCAO were also comparable between the two genotypes. However, cerebral infarct size at 24 hours after transient MCAO was markedly reduced in the triple NOSs -/- genotype as compared with the wild-type genotype ( P &lt;0.05). Cerebral infarct size at 24 hours after permanent MCAO was also markedly smaller in the triple NOSs -/- than in the wild-type genotype ( P &lt;0.05). In addition, neurological deficit was significantly less and the survival rate was significantly better in the triple NOSs -/- genotype compared with the wild-type genotype (each P &lt;0.05). Importantly, 3-nitrotyrosine protein levels (a marker of peroxynitrite production) in the cerebral infarct region were significantly decreased in the triple NOSs -/- genotype as compared with the wild-type genotype ( P &lt;0.05), suggesting an involvement of decreased oxidative stress. Conclusions: These results provide the first evidence that complete disruption of all NOS genes markedly reduces cerebral infarct size after MCAO in mice, demonstrating a novel injurious role of the entire NOSs system in the pathogenesis of cerebral infarction. Inhibition of the NOSs system may be a new therapeutic option in the treatment of cerebral infarction.
Abstract 13288: Higher Non-High Density Lipoprotein Cholesterol is Associated With Arterial-Ventricular Stiffening in Childhood Obesity
Authors: Kenji Harada, Yukiko Harada, Manatomo Toyono
Journal: Circulation (2015)

Background: Serum non-high density lipoprotein cholesterol (HDLC) is known to be a good predictor of cardiovascular events. However, few studies have examined non-HDLC and cardiovascular function in overweight/obese children. The purpose of this study is to assess the relationship between non-HDLC and cardiovascular function in children. Methods: Echocardiography was performed in 243 children aged 7 to 15 years (BMI 18 to 34 kg/m2). Left ventricular (LV) end-diastolic volume, LV mass, transmitral peak flow velocity (E), and mitral annular myocardial velocity (Em) were measured. LV mass/volume ratio was calculated. Stroke volume (SV) was measured using aortic diameter and pulsed Doppler velocity profile. SV was indexed for body surface area (SVI). Effective arterial elastance (Ea) was estimated by end-systolic pressure/SVI. End-systolic elastance (Ees) was calculated by a modified single-beat method. End-diastolic elastance (Ed) was calculated from Doppler indices reflective of atrial pressures (E/Em) and the diastolic filling volume (SV). Lipids, uric acid, fasting glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and high sensitive C-reactive protein (hs-CRP) were also assessed. Results: Ea, Ees, and Ed all increased significantly with BMI(r = 0.30, 0.26, and 0.18, p &lt; 0.01, respectively). There were significant relationships between BMI and non-HDLC, HDLC, uric acid, triglycerides, HOMA-IR, and hs-CRP (r = 0.21, -0.32, 0.48, 0.37, 0.37, 0.52, and 0.39, p &lt; 0.01, respectively). Ea correlated significantly with non-HDLC, HDLC, uric acid, triglycerides, HOMA-IR, and hs-CRP (r = 0.20, -0.15, 0.18, 0.23, 0.22, and 0.14, p &lt; 0.05, respectively). There were significant relationships between Ees and non-HDLC, uric acid, triglycerides, and HOMA-IR (r = 0.25, 0.20, 0.16, and 0.17, p &lt; 0.05, respectively). Ed correlated significantly with non-HDLC (r = 0.18, p &lt; 0.05). In multiple regression analysis, non-HDLC was independent determinants of Ea, Ees, and Ed. Conclusions: Higher non-HDLC and combined arterial-ventricular stiffening may contribute to the increased prevalence of later cardiovascular disorder.
Abstract 15633: Inaccuracy of Friedewald-Estimation at Clinically Relevant Very Low Levels of LDL-Cholesterol: The Very Large Database of Lipids Study 1C
Authors: Renato Quispe, Aditya Hendrani, Mohamed B Elshazly, Erin D Michos, John W McEvoy, Michael J Blaha, Peter P Toth, Josef Coresh, Roger S Blumenthal, Steven R Jones, Seth S Martin
Journal: Circulation (2015)

Background: Appropriate classification of low-density lipoprotein cholesterol (LDL-C) in the very low range has direct relevance to patient care and clinical trials. Some guidelines recommend targeting an LDL-C &lt;70 mg/dL for high-risk patients or consideration of statin down-titration at levels &lt;40 mg/dL. Moreover, recent lipid-lowering trials have classified many participants with an LDL-C &lt;50 and even &lt;25 mg/dL. Objectives: Previously, we showed significant underestimation of Friedewald-estimated LDL-C (LDLf-C) compared with directly-measured LDL-C (LDLd-C) at low LDL-C and high triglycerides (TG). We now seek to extend these findings to persons with very low LDLf-C levels. Methods: We analyzed 191,333 US adults from the Very Large Database of Lipids with LDLf-C &lt;70 mg/dL and TG &lt;400 mg/dL. We calculated the median difference by subtracting LDLd-C from LDLf-C. Upward reclassification by LDLd-C vs LDLf-C was calculated based on several cutpoints: 25, 40, 50, and 70 mg/dL (0.2th, 1.3th, 3.6th, 14.7th percentile, respectively). Results: Patients were 65±15 years old and 60% men. Greater underestimation was found at lower LDLf-C and higher TG levels. The median difference (25th to 75th percentile) increased from -2 (-7 to 1) at LDLf-C 60-69 mg/dL to -30 (-37 to -22) at LDLf-C &lt;10 mg/dL in the overall population, and from -16 (-22 to -12) to -32 (-39 to -26), respectively, in patients with TG 200-399 mg/dL. Among individuals with LDLf-C lower than 25, 40, 50, and 70 mg/dL cutpoints, 82%, 57%, 43%, and 23% had LDLd-C higher than those levels. Reclassification occurred most commonly in those with high TG (Table). Conclusion: Extending our prior work on Friedewald LDL-C underestimation at levels &lt;70 mg/dL, we now show even more substantial misclassification at very low LDL-C levels (&lt;25, 40, 50 mg/dL), particularly at high TG. These findings likely have relevance for personalized clinical decision-making and for clinical trial design using more potent lipid lowering agents.
Abstract 10342: Frailty Status and Outcomes Following Trans-catheter Aortic Valve Replacement
Authors: Chetan P Huded, Jill M Huded, Lee A Lindquist, Thomas A Holly, Ranya N Sweis, Mark J Ricciardi, Sukit C Malaisrie, Charles J Davidson, James D Flaherty
Journal: Circulation (2015)

Introduction: Frailty is associated with increased disability, morbidity, and mortality. We assessed the impact of frailty status on outcomes following trans-catheter aortic valve replacement (TAVR). Methods: We included all 142 patients who underwent prospective modified Fried frailty assessments prior to TAVR at a single tertiary care academic medical center between February, 2012 and February, 2015 in a retrospective cohort study. We stratified patients into 3 groups (non-frail, pre-frail, and frail). The primary outcome was a composite of 30 day mortality, stroke, acute kidney injury &gt; stage 2, major vascular injury, major or life-threatening bleeding, valve malpositioning, conversion to sternotomy, and respiratory failure. Secondary outcomes included length of hospital stay, discharge destination, hospital re-admission within 30 days, and overall survival. Results: Non-frailty was present in 39 patients (27%), pre-frailty in 64 patients (45%), and frailty in 39 patients (27%). Mean age increased with increasing frailty status (non-frail 80.1 +/- 9.3 years, pre-frail 84.0 +/- 8.2 years, frail 84.7 +/- 7.1 years, P=0.03). There was no difference in the mean Society of Thoracic Surgeons risk score between groups. There was no difference in the rate of the primary composite endpoint, length of hospital stay, rate of hospital re-admission within 30 days, or overall survival between the groups. Frail patients had a higher rate of discharge to a rehabilitation facility (non-frail 23%, pre-frail 23%, frail 51%, P&lt;0.01). In a multivariable logistic regression, frailty was a significant independent predictor of discharge to a rehabilitation facility (table). Conclusions: Outcomes following TAVR are not impacted by pre-frailty, while frail patients are less likely to be discharged directly home.
Abstract 11601: Identifying Patients at High Risk for Poor Global Outcome After Left Ventricular Assist Device for Destination Therapy: Results From the INTERMACS Registry
Authors: Suzanne V Arnold, Philip G Jones, Larry A Allen, David J Cohen, Timothy J Fendler, Jonathan E Holtz, Sanjeev Aggarwal, John A Spertus
Journal: Circulation (2015)

Introduction: LVAD for destination therapy (DT-LVAD) improves survival and quality of life (QOL) for many, but not all, patients with end-stage heart failure who are ineligible for transplantation. To aid in decision-making and help calibrate patients’ expectations of recovery, we evaluated the frequency and predictors of poor global outcome using a composite measure that integrates QOL with mortality. Methods: Within the INTERMACS national registry, QOL was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ-OS). Poor outcome was defined as death or an average KCCQ-OS &lt;45 over the year following LVAD (i.e., continued NYHA IV symptoms despite LVAD). Inverse propensity weighting was used to adjust for loss to follow-up. Predictors of poor outcome were assessed using logistic regression with 18 demographic and clinical factors, with parameter estimates penalized to minimize the effect of over-fitting. Validation was conducted using bootstrap methods. Results: Among 1487 patients who underwent DT-LVAD, 30% had a poor outcome, with death in 23% and very poor QOL in 7%. Higher BMI (OR 1.12 per 5kg/m2, 95% CI 1.02-1.24), older age (OR 1.23 per 10y, 95% CI 1.08-1.40), and pre-implant poor QOL (OR 1.10 per 10pt lower KCCQ-OS, 95% CI 1.02-1.18) were significant predictors of poor global outcome, with trends for a history of cancer (OR 1.39, 95% CI 0.96-2.01) and INTERMACS profile 1-2 (i.e., critically ill with heart failure; OR 1.27, 95% CI 0.97-1.65). The model had moderate discrimination (c-index=0.64, validated=0.62), good calibration, and identified 10% of patients with a ≥40% risk of poor outcome. At 1 year, 33% of these high risk patients were dead and an additional 15% had very poor QOL. Conclusions: Nearly one-third of patients have poor outcomes over the year after DT-LVAD. We developed a simple predictive model that can identify patients’ risk for a poor global outcome after DT-LVAD to enable more realistic expectations of outcomes for individual patients.